Supporting Canine Urinary Health
CystoPro
www.protexinvet.com
®
Presentation
Each capsule of CystoPro contains:
• 20mg Proanthocyanidins
• 125mg N-acetyl D-glucosamine
• Enterococcus faecium (NCIMB 10415) E1707
1x1011 CFU/kg
• Mannan-oligosaccharide
• Artificial chicken flavour
Protexin VeterinaryLopen Head, Somerset, TA13 5JH, United KingdomTelephone +44 (0)1460 243230 Fax +44 (0)1460 249543www.protexinvet.com
Protexin and CystoPro are registered trademarks of Probiotics International Ltd. All rights reserved. B1074
References:
1. Ling GV. 1984. Therapeutic strategies involving antimicrobial treatment of the canine urinary tract. J Am Vet Med Assoc. 185: 1162-1164.
2. Lees GE. 1996. Bacterial urinary tract infections. Vet Clin North Am Small Anim Pract. 26: 297-304.
3. Thomsen MK, Svane LC, Poulsen PH. 1986. Canine urinary tract infection. Detection, prevalence and therapeutic consequences of bacteriuria. Nord Vet Med. 38: 394-402.
4. Ling GV, Norris CR, Franti CE, et al. 2001. Interrelations of organism prevalence, specimen collection method, and host age, sex, and breed among 8,354 canine urinary tract infections (1969-1995). J Vet Intern Med. 15: 341-347.
5. Forrester SD, Troy GC, Dalton MN, Huffman JW, Holtzman G, 1999. Retrospective evaluation of urinary tract infection in 42 dogs with hyperadrenocorticism or diabetes mellitus or both. J Vet Intern Med. 13: 557–560.
6. Wooley RE, Blue JL. 1976. Bacterial isolations from canine and feline urine. Mod Vet Pract. 57: 535-538.
7. Barsanti JA. 2006. Genitourinary infections. In: Greene CE, ed. Infectious diseases of the dog and cat. Edition 3. St Louis: Saunders: 935-961.
8. Bubenik LJ, Hosgood GL, Waldron DR, Snow LA. 2007. Frequency of urinary tract infection in catheterized dogs and comparison of bacterial culture and susceptibility testing results for catheterized and non-catheterized dogs with urinary tract infections. J Am Vet Med Assoc. 231(6): 893-9.
9. Howell AB et al. 2010. Dosage effect on uropathogenic Escherichia coli anti-adhesion activity in urine following consumption of cranberry powder standardized for proanthocyanidin content: a multicentric randomized double blind study. BMC Infectious Disease. 10: 94.
10. Reid G et al. 2001. Cranberry juice consumption may reduce biofilms on uroepithelial cells: Pilot study in spinal cord injured patients. Spinal Cord. 39: 26-30.
11. Howell AB, Griffin DW, Whalen MO. 2011. Standardized cranberry tablet inhibits uropathogenic bacterial adhesion in canine urine. Poster presented at Berry Health Benefits Symposium.
Body weight Number of capsules per day
<20kg 1 capsule
20-40kg 2 capsules
40-60kg 3 capsules
Directions For Use
Capsules can be given whole or opened and the
contents sprinkled onto food.
Give for as long as considered necessary or as
advised by your veterinary surgeon.
CystoPro is available in boxes of 30 and 120 capsules
CystoProCystoProSupporting Canine Urinary Health
Canine Urinary Tract InfectionsA urinary tract infection (UTI) involves adherence, multiplication, and persistence of an infectious agent within the urogenital system.
Infections may involve commensal bacterial
organisms normally present in the distal
urogenital tract, or may result from ascending
infections by faecal or cutaneous organisms.
Less commonly, infections may be iatrogenic or
haematological in origin.
Bacterial UTIs affect 14% of all dogs during their
lifetime1, and are more common in females2,3,4.
Dogs with diabetes mellitus,
hyperadrenocorticism (Cushing’s
Disease) or treated chronically with
steroids have more bacterial UTIs
than normal dogs and have a higher
percentage of E.coli UTIs5.
Use of indwelling urinary catheters in hospitalised dogs resulted in 55% developing a UTI8.
The first step in infection is attachment of the
bacteria to the bladder urothelium followed by
colonisation and proliferation. Specific types of
fimbriae (P-fimbriae) on E.coli facilitate this
adhesion.
E.coli is the most common canine urinary tract
pathogen accounting for approximately 33-50%
of canine UTI cases4,6,7.
Escherichia coli
Staphylococcus spp.
Proteus spp.
Klebsiella spp.
Streptococcus spp.
Bacterial isolate Percentage of total isolates4
Percentage (%)
0 10 20 30 40 50 60 70 80 90 100
44.1%
11.6%
9.3%
9.1%
5.4%
A single bacterial pathogen is isolated from
approximately 75% of bacterial UTIs in dogs, 20%
of UTIs are caused by two co-infecting species, and
approximately 5% are caused by three species4.
Clinical Signs and Treatment
Clinical Signs TreatmentDogs with a UTI may or may not be symptomatic.
Clinical signs associated with a UTI are variable
and depend on the virulence and number of
uropathogens, presence of concurrent disease,
health of the immune system, duration of
infection, and site(s) of infection.
Clinical signs may include:
• Pollakiuria
• Stranguria
• Dysuria
• Haematuria
• Inappropriate urination
Owners can also report urinary incontinence
between urinations and an offensive odour
to the urine.
A large proportion of canine patients with
a UTI exhibit minimal clinical signs.
Antimicrobials are often the treatment of choice for
UTIs and should be based on culture and sensitivity
of a urine sample collected via cystocentesis.
E.coli is becoming increasingly resistant to antibiotics.
The rate of bacterial resistance is greatest in dogs
with recurrent E.coli infections.
Reasons for failure of treatment can include:
• Inappropriate drug, dose, or duration of therapy.
Owner compliance is critical
• Failure of the drug to reach sufficient
concentrations in urine despite drug administration
• Presence of nidus of infection (urolithiasis, neoplasia)
• Anatomical defect
P A G E 2 Supporting Canine Urinary Health Supporting Canine Urinary Health P A G E 3
Introducing CystoProHigh Level Support for Canine Urinary Health.
Ingredients
Proanthocyanidins (PACs)Proanthocyanidins are naturally occurring
powerful antioxidants extracted from the North
American cranberry. PACs inhibit the ability
of E.coli to attach to the urothelium, thereby
preventing bacterial adherence, colonisation
and infection.
ProbioticThe EU-registered strain Enterococcus faecium
(NCIMB 10415) E1707 acts to reduce pathogenic
bacteria within the gastrointestinal tract thereby
reducing the risk of ascending UTIs of faecal origin.
Mannan-oligosaccharideCreated from purified yeast cell walls,
Mannan-oligosaccharide (MOS), binds E.coli
and upregulates the innate immune system by
attracting phagocytes to opsonise the bacteria.
MOS is commonly used as a prebiotic to support
intestinal microflora.
N-acetyl D-glucosamineN-acetyl D-glucosamine is a precursor to
Chondroitin sulphate and Keratin sulphate
which make up the Glycosaminoglycan (GAG)
layer that lines and protects the sensitive
bladder urothelium.
A strong, resilient GAG layer prevents bacteria
from adhering to the urothelial cells.
Artificial Chicken FlavourFor enhanced palatability.
The Glycosaminoglycan (GAG) Layer of the Bladder
Urine
Glycosaminoglycan Layer
Urothelium
Serosa
Chondroitin SulphateGlycosaminoglycan
Keratin Sulphate
Urethra
Bladder
Ureter
Link Protein
Protein Core
Mucin
Hyaluronic Acid
{
The luminal surface of the urinary
tract is covered by a protective
barrier of glycosaminoglycans (GAG).
Glycosaminoglycans are negatively
charged polysaccharide chains that
help prevent microbes adhering to
the sensitive urothelium.
The GAG layer responds to
uropathogenic Escherichia coli (UPEC)
infection by increasing in thickness to
reinforce its defensive properties.
P A G E 4 Supporting Canine Urinary Health Supporting Canine Urinary Health P A G E 5
Proanthocyanidins (PACs) are a class of biologically
active flavonoids and are one of the most potent
antioxidants in nature. PACs reduce the ability
of E.coli bacteria to establish infection in the
lower urinary tract9.
PACs are sourced from the North American cranberry,
Vaccinium macrocarpon, and they are unique in that
they contain A-type linkage versus the B-type linkage
found in many other PACs. This linkage is believed to
contribute to the anti-adhesion activity of the PACs.
Attachment of the P-fimbriated E.coli to the
bladder urothelium15, followed by colonisation
and proliferation (Figure 1).
Proanthocyanidins
PACs work by inhibiting the adhesion of
P-fimbriated E.coli to the urothelium (Figure 2).
By preventing the bacterial attachment to the
urothelium of the lower urinary tract, the
bacteria fail to colonise and are instead voided
in the urine (Figure 3).
PACs have been shown to have an effect on
biofilm formation within the bladder. PAC
administration for 1 week resulted in a reduction
of urothelial biofilm formation as compared with
water consumption10.
What is a biofilm?A biofilm is a collection of bacteria
adhering to each other (and/or to a
surface) and are frequently within a
self-produced matrix of extracellular
material consisting of DNA, proteins and
polysaccharides. This matrix provides
protection to the bacteria and may aid in
protecting them from antibiotics.
Figure 1
Figure 3
Figure 2
PACs administered to canine patients at 1mg/kg
bodyweight daily for 3 weeks exhibited significant
ex vivo anti-adhesion activity against E.coli11.
Six male beagle dogs (3-8 years old) were given a
standardised cranberry extract (1mg/kg PACs) daily
for 21 days. Urine samples were collected on days
1, 3, 5, 7 and 21 and tested in an ex vivo assay
for the ability to agglutinate human red blood
cells (HRBC) specific for P-fimbriated E.coli.
Proanthocyanidins
Mea
n %
act
ivity
100 -
80 -
60 -
40 -
20 -
0 -
Days of dosing1
21%26%
73%80% 82%
3 5 7 21
Mean daily anti-adhesion activity against E.coli
The results of the study demonstrate that
PACs reduce the ability of E.coli to adhere
to and colonise the urinary tract.
P A G E 6 Supporting Canine Urinary Health Supporting Canine Urinary Health P A G E 7